Active NPI
Jody Davis, NP
- Nurse Practitioner
- San Antonio, TX
National Provider Identifier
1548373764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 565511
- Practice address
- 527 N Leona St
San Antonio, TX 78207-3110 - Phone
- (210) 358-3595
- Fax
- (210) 358-1670
- NPI assigned
- Aug 15, 2006
- Last updated
- May 6, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 565511 | TX | Primary |
Addresses
Primary practice location
527 N Leona St
San Antonio, TX 78207-3110
Mailing address
527 N Leona St
San Antonio, TX 78207-3110
Phone (210) 358-3595
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 070817404 | Other | TX | CIDC |
| 070817402 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 565511 | TX | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241568000000",
"number": "1548373764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "527 N LEONA ST",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782073110",
"telephone_number": "210-358-3595",
"fax_number": "210-358-1670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "527 N LEONA ST",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782073110",
"telephone_number": "210-358-3595",
"fax_number": "210-358-1670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JODY",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-15",
"last_updated": "2009-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "TX",
"license": "565511",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIDC",
"identifier": "070817404",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "070817402",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.